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CASE DISCUSSION:

DEMOGRAPHIC DETAILS:  A 42year old female patient,came  with severe edema along with G6PD& AMPD1 deficiency. CHIEF COMPLAINTS. 1) Frequent falls to the left. Left foot started giving out as well as hand. one fall down stairs sprained and broke ankle (last year) X-ray below. Poor stress response. 2) Swelling/ hair loss (head and eyelashes) Fatigue. Left jaw pain up into face. 3) Breathing difficulties. 4)intolerance from most foods, smoke.   5)Always less urination which increase when fasting. 6)Sleep was bad with 2-4 hours. Drug history: 1) L-Serine 20 gm at night,  2)Ribose 2 gm every hour in water, if any major exercise or exertion.  3)400mg cimitidine 4)600mg NAC 5)Iron folate 500% of RDA  PATIENT HISTORY.(main points) Birth - 1 year. Severe Jaundice Did not sleep. (very less, 2-4 hours only once in a day) 3 Year Began shaving. Excessive hair growth on face/neck/toes/ and legs. Still only sleeping 2-3 hours. 4 Years Chronic UTI Kidney infections Strep throat Lung infections Mult